Pharm Chapter 35 - Study Notes
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Questions and Answers

When administering insulin to a patient, which intervention is most crucial for successful diabetes management?

  • Frequent follow-up with the healthcare provider
  • Preventative education
  • The level of self-management (correct)
  • A network of community resources

Which laboratory test is the recommended screening tool for diabetes in children and adults without pregnancy?

  • Glycated Hemoglobin (A1c)
  • Electrocardiogram (ECG)
  • Glucose Tolerance Test (GTT)
  • Fasting Plasma Glucose (FPG) (correct)

How do sulfonylureas primarily work to regulate blood glucose levels?

  • Enhancing insulin breakdown in the liver
  • Stimulating the pancreas to release more insulin (correct)
  • Boosting glucose production in the liver
  • Inhibiting the release of insulin from the pancreas

Which statement made by the patient demonstrates a need for further education about insulin administration?

<p>Once I open my insulin, I will store it in the refrigerator. (A)</p> Signup and view all the answers

A patient with diabetes inquires about the significance of their A1c test result. What is the most appropriate explanation for this test?

<p>A1c reflects your average blood sugar levels over the past 3 months. (B)</p> Signup and view all the answers

What is the recommended time frame for a patient to consume their meal after receiving an insulin injection?

<p>10 to 15 minutes after the injection (A)</p> Signup and view all the answers

Which of the following actions is essential to prevent complications associated with diabetes?

<p>All of the above (D)</p> Signup and view all the answers

What is the primary rationale for teaching patients with diabetes to self-manage their condition?

<p>To empower patients to effectively control their disease (D)</p> Signup and view all the answers

What are the caloric recommendations for a diabetic patient on a consistent carbohydrate diabetes meal plan?

<p>1500 to 2000 calories per day with 50% from carbohydrates, 20% from protein, and 30% from fat (C)</p> Signup and view all the answers

Which of the following factors may require adjustments to the consistent carbohydrate diabetes meal plan?

<p>All of the above (D)</p> Signup and view all the answers

What is the primary consideration when calculating calorie requirements for a diabetic patient?

<p>Consistency of meal timing (B)</p> Signup and view all the answers

Which of the following is NOT a contributing factor to the development of type 2 diabetes mellitus?

<p>Being younger than 45 years (B)</p> Signup and view all the answers

What is a common characteristic of type 2 diabetes mellitus that often leads to delayed diagnosis?

<p>Minimal early symptoms (D)</p> Signup and view all the answers

What is the role of the pancreas in type 2 diabetes mellitus?

<p>It continues to secrete insulin, but the body's cells become resistant to it. (B)</p> Signup and view all the answers

Which of the following treatment options is typically used for type 2 diabetes mellitus if diet and oral medications are ineffective?

<p>Insulin therapy (B)</p> Signup and view all the answers

Which of the following statements about type 2 diabetes mellitus are TRUE? (Select all that apply)

<p>It is often diagnosed after complications have resulted. (A), It can be prevented with a healthy lifestyle. (C)</p> Signup and view all the answers

A patient is experiencing symptoms of hypoglycemia after receiving a subcutaneous injection of Lispro at 4:30 PM. What is the most likely time the patient would experience these symptoms?

<p>5:30 PM (B)</p> Signup and view all the answers

A patient is experiencing symptoms of hypoglycemia and has a blood glucose level of 50 mg/dL. Which action is most important for the nurse to take?

<p>Administer glucagon subcutaneously. (D)</p> Signup and view all the answers

A patient is scheduled for a bronchoscopy and has been NPO since midnight. They are experiencing symptoms of hypoglycemia with a blood glucose level of 50 mg/dL. Which action is most important for the nurse to take?

<p>Administer glucagon subcutaneously. (B)</p> Signup and view all the answers

A patient is prescribed 4 units of Lispro and 8 units of NPH insulin. Which of the following actions should the nurse take when administering these medications?

<p>Draw up Lispro first and then NPH in the same syringe. (A)</p> Signup and view all the answers

A patient has a blood glucose reading of 140 mg/dL. The patient is prescribed 4 units of Lispro and 8 units of NPH insulin. Which statement is correct regarding administering these medications?

<p>The nurse should administer both Lispro and NPH in the same syringe before the patient’s next meal. (B)</p> Signup and view all the answers

A patient is scheduled for a bronchoscopy procedure and has been NPO since midnight. The patient's blood glucose level reads 50 mg/dL. In addition to administering glucagon, which additional action should the nurse take?

<p>Contact the physician for further instructions. (D)</p> Signup and view all the answers

A patient is prescribed Lispro and NPH insulin. Which of the following statements is TRUE regarding administering these medications?

<p>Lispro should be drawn up into the syringe first, followed by NPH. (D)</p> Signup and view all the answers

A patient receives a subcutaneous injection of Lispro insulin at 4:00 PM. What is the most likely time that the peak effect of the insulin would occur?

<p>5:00 PM (A)</p> Signup and view all the answers

Which of the following statements accurately describes the early symptoms of Type 2 Diabetes Mellitus?

<p>Early symptoms are typically minimal, causing delayed medical intervention. (D)</p> Signup and view all the answers

What is the primary treatment approach for patients with Type 2 Diabetes Mellitus?

<p>Oral hypoglycemics are typically the initial treatment option. (A)</p> Signup and view all the answers

What is a significant factor in the development of Type 2 Diabetes Mellitus?

<p>A sedentary lifestyle. (C)</p> Signup and view all the answers

Which of these statements accurately describes gestational diabetes?

<p>Gestational diabetes is a temporary condition only affecting pregnant women. (B)</p> Signup and view all the answers

What is a potential long-term consequence of gestational diabetes?

<p>Increased risk of developing Type 2 Diabetes after pregnancy. (B)</p> Signup and view all the answers

When is urine ketone testing recommended for individuals with diabetes?

<p>During periods of illness or when blood sugar is elevated. (B)</p> Signup and view all the answers

What is the recommended frequency for urine ketone testing for individuals with diabetes?

<p>As needed, based on symptoms or blood sugar levels. (C)</p> Signup and view all the answers

During a hospital stay, a type 2 diabetic patient who typically manages their diabetes with oral medication needs additional insulin. What is the most likely reason for the need for insulin?

<p>The patient is experiencing increased stress, leading to higher blood glucose levels. (A)</p> Signup and view all the answers

What is the primary advantage of using an insulin analog like Lispro compared to regular insulin?

<p>Lispro has a faster onset of action, allowing for better control of post-meal blood sugar spikes. (C)</p> Signup and view all the answers

A patient with type 2 diabetes is admitted to the hospital for a leg ulcer. The healthcare provider orders sliding scale insulin coverage with regular insulin for hyperglycemia. The patient expresses concern about starting insulin. Which of the following is the best response by the nurse?

<p>Your body is under stress right now, which raises your blood glucose level. This does not mean you will be on this drug permanently. Once you're feeling better, your provider will determine if your oral medication is all you will need. (B)</p> Signup and view all the answers

A laboratory test measures the percentage of hemoglobin that has been irreversibly glycosylated due to high blood glucose levels over a period of 8 to 10 weeks. This test is known as the:

<p>A1c test (D)</p> Signup and view all the answers

What is the most relevant factor in determining the appropriate time to administer rapid-acting insulin analogs like Lispro?

<p>The timing of the patient's meals. (D)</p> Signup and view all the answers

Which of the following tests provides an indication of average blood glucose levels over the past 1 to 3 weeks?

<p>Fructosamine test (A)</p> Signup and view all the answers

What is the typical onset of action for rapid-acting insulin analogs like Lispro?

<p>Within 10 to 15 minutes of injection (C)</p> Signup and view all the answers

A patient with type 2 diabetes has been admitted to the hospital for an infection. Why might this patient require insulin therapy despite previously managing their diabetes with oral medication?

<p>The patient's stress levels are elevated, which can increase blood glucose levels. (C)</p> Signup and view all the answers

A patient newly diagnosed with diabetes asks about the appropriate use of insulin. Which statement indicates the patient needs further teaching?

<p>I should keep my insulin in the refrigerator until I open it. (A)</p> Signup and view all the answers

Which instruction is most important for the nurse to teach a patient with diabetes who is taking beta-blockers?

<p>Beta-blockers can mask symptoms of hypoglycemia. (D)</p> Signup and view all the answers

A patient with diabetes is prescribed Metformin. Which instruction is most important for the nurse to emphasize before a radiopaque dye procedure?

<p>Avoid taking Metformin for 24 to 48 hours before the procedure. (D)</p> Signup and view all the answers

Which statement indicates that the patient with a new diagnosis of type 1 diabetes understands the need for insulin?

<p>I will need to take insulin for the rest of my life. (D)</p> Signup and view all the answers

When providing teaching for a patient with diabetes who is receiving insulin, the nurse should include instructions regarding lipodystrophy. Which statement about lipodystrophy is accurate?

<p>Lipodystrophy can lead to decreased insulin absorption at the injection site. (C)</p> Signup and view all the answers

The patient with diabetes asks the nurse about how infection influences insulin needs. Which statement by the nurse is accurate?

<p>Infection will increase the need for insulin. (B)</p> Signup and view all the answers

A patient with diabetes is concerned about the impact of exercise on their blood sugar levels. How should the nurse respond?

<p>Exercise will decrease your blood sugar levels. (A)</p> Signup and view all the answers

Which statement about metformin is accurate?

<p>Metformin should be discontinued for 24 to 48 hours before procedures involving radiopaque dyes. (A)</p> Signup and view all the answers

Flashcards

Hypoglycemia onset with Lispro

Symptoms of hypoglycemia with Lispro occur 1-2 hours post-injection.

Symptoms of hypoglycemia

Signs include headache, irritability, shakiness, and cold sweats.

Treatment priority for hypoglycemia

Administer glucagon for immediate glucose increase in severe cases.

NPO status significance

NPO means no food or drink intake, crucial before procedures.

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Administering Lispro and NPH

Draw up Lispro first, then NPH when mixing insulins.

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Timing for Lispro administration

Lispro should be given before meals due to rapid onset.

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Blood glucose reading interpretation

A reading of 50 mg/dL indicates severe hypoglycemia needing urgent action.

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Insulin compatibility

Lispro and NPH can be mixed due to compatibility of action types.

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Insulin Storage Duration

Opened insulin can be stored at room temperature for up to 1 month.

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Type 2 diabetes and insulin

Patients may need insulin during increased stress, despite prior oral medications.

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Sliding scale insulin coverage

A method of adjusting insulin dosage based on blood glucose levels.

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Beta Blockers and Hypoglycemia

Beta blockers can mask symptoms of hypoglycemia in diabetics.

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Metformin and Radiopaque Dye

Stop Metformin 24 to 48 hours before radiopaque dye procedures.

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A1c test

Measures average blood sugar over the previous 8 to 10 weeks.

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Insulin in Type 1 Diabetes

Type 1 diabetes requires lifelong insulin injections.

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Fructosamine test

Measures glucose bonded to protein reflecting 1 to 3 weeks average glucose levels.

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Exercise for Diabetics

Diabetics benefit from regular cardiovascular exercise.

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Lispro insulin administration timing

Lispro should be given within 10 to 15 minutes of eating.

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Dietary Fat in Diabetes

A diabetic diet should include 20% to 35% of calories from fat.

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Effects of stress on blood sugar

Stress raises blood glucose through hormones like epinephrine and norepinephrine.

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Self-Glucose Testing Skills

Patients with diabetes should demonstrate accurate self-glucose testing skills.

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Regular insulin usage

Stronger dose of insulin used when hospitalized to manage higher blood glucose.

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Insulin onset and peak

Rapid-acting insulins like Lispro have a 10-minute onset and peak in 1-2 hours.

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Lipodystrophy and Insulin Absorption

Lipodystrophy does not increase insulin absorption.

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Timing of meals after injection

Patients should eat their meal within 10 to 15 minutes after an injection.

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Importance of self-management in diabetes

Patients must manage all aspects of diabetes to succeed, including diet, medication, and complication prevention.

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Preferred diabetes screening test

Fasting Plasma Glucose (FPG) is the preferred screening test for diabetes in children and non-pregnant adults.

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Sulfonylureas mechanism

Sulfonylureas stimulate the pancreas to secrete more insulin, normalizing glucose levels.

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Insulin storage after opening

Once opened, insulin should be stored in the refrigerator to maintain potency.

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Preventative education in diabetes

Education is essential for patients to prevent complications but is not a substitute for self-management.

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Monitoring diabetes management

The A1c test monitors diabetes management over 90-day intervals.

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Common response needs teaching

A patient saying they may need more insulin for surgery indicates a need for further teaching about insulin management.

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Diabetes Meal Plan

A plan emphasizing consistent carbohydrate intake for diabetic patients.

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Carbohydrate Distribution

For diabetic meal planning, 50% of calories come from carbohydrates.

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Protein Intake

Diabetic patients should get 20% of their calories from protein.

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Type 2 Diabetes Risk Factors

Includes being older than 45, overweight, and having family history.

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Incidence in Women

Women have a higher incidence of type 2 diabetes compared to men.

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Complications in Diagnosis

Type 2 diabetes is often diagnosed after complications arise.

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Chronic Condition

Type 2 diabetes is a chronic condition requiring ongoing management.

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Type 2 Diabetes Symptoms

Early symptoms are minimal, complicating diagnosis.

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Gestational Diabetes Incidence

Diagnosed in about 4% of pregnancies in the US.

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Gestational Diabetes Risks

Increases risk of diabetes after pregnancy.

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Normal Glucose Tolerance Postpartum

Most women with gestational diabetes return to normal.

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Ketone Testing for Diabetics

Test when ill, during pregnancy, or high glucose.

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Insulin Use in Type 2 Diabetes

Insulin is used only if other treatments fail.

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Reclassification of Gestational Diabetes

Women reassessed 6 weeks post-delivery.

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Oral Hypoglycemics in Type 2 Diabetes

Patients may be managed with diet or medications.

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Study Notes

Pharm Chapter 35 - Study Notes

  • Hypoglycemia Symptoms Timing: Symptoms of hypoglycemia after Lispro injection are most likely to occur around 1 to 2 hours after administration.

  • Bronchoscopy Patient: A patient with a blood glucose of 50 mg/dL experiencing shakiness, headache, and irritability after a 12 AM NPO period for bronchoscopy should receive glucagon subcutaneously.

  • Insulin Administration: Lispro, a rapid-acting insulin, should be drawn up and administered before NPH (intermediate-acting) insulin in the same syringe.

  • Type 2 Diabetes Mellitus: A patient with controlled type 2 diabetes requiring hospitalization for a leg ulcer should not have concerns about receiving sliding scale insulin. Insulin is a temporary treatment while in the hospital, and oral medications are often resumed upon discharge discussion.

  • Glycemic Control Test: The A1c test determines long-term glycemic control (8-10 weeks).

  • Lispro Insulin Administration Timing: Lispro insulin should be administered 10-15 minutes before eating.

  • Diabetes Mellitus Management: Self-management is crucial for successful diabetes management, including diet, exercise, and medications.

  • Diabetes Screening: The fasting plasma glucose (FPG) is the preferred screening test for diabetes in children and non-pregnant adults.

  • Sulfonylureas Action: Sulfonylureas stimulate the pancreas to secrete more insulin, decrease glucose production, and improve insulin metabolism.

  • Insulin Storage: Opened insulin can be stored at room temperature for up to 1 month.

  • Diabetes and Beta Blockers: Beta blockers can mask the symptoms of hypoglycemia.

  • Diabetes and Metformin: Metformin should be discontinued 24-48 hours before procedures using radiopaque dyes.

  • Type 1 vs. Type 2 Diabetes Symptoms: Impotence, increased thirst, weight loss, and polyphagia could suggest Type 1 diabetes rather than Type 2.

  • Type 2 Diabetes Prevalence: Type 2 diabetes is most prevalent in overweight individuals over 45.

  • Gestational Diabetes: Gestational diabetes often results in normal glucose tolerance after pregnancy, but women should still be monitored.

  • Ketone Testing Timing: Ketone testing is important during illness, pregnancy, and elevated blood glucose. Testing isn't required before/after exercise or every morning.

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Description

This quiz covers key concepts from Chapter 35 of Pharmacy, focusing on insulin administration, hypoglycemia symptoms, and the management of Type 2 Diabetes Mellitus. Test your knowledge on the correct timing of insulin and its implications for patient care, especially in acute settings. Prepare for better glycemic control understanding and insulin protocols.

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